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Transseptal left heart catheterisation in infants, children, and young adults
M A Ali Khan1, C E Mullins, S E Bash
1Riyadh Cardiac Centre, Armed Forces Hospital, Kingdom of Saudi Arabia.
Insights
Transseptal left heart catheterization is a safe and effective procedure for diagnosing and treating congenital and acquired heart conditions in pediatric patients. This technique avoids femoral artery catheterization and has a high success rate with minimal complications.
Area of Science:
- Pediatric Cardiology
- Interventional Cardiology
- Cardiac Catheterization
Background:
- Congenital and acquired heart diseases require accurate diagnosis and treatment.
- Left heart catheterization is crucial for evaluating cardiac function and structure.
- Traditional retrograde catheterization via femoral arteries can be challenging in pediatric patients.
Purpose of the Study:
- To evaluate the safety and efficacy of transseptal left heart catheterization in infants, children, and young adults.
- To assess the utility of this technique for both diagnostic and interventional procedures.
- To compare transseptal catheterization with retrograde femoral catheterization.
Main Methods:
- Transseptal left heart catheterization using the Mullins long-sheath technique was performed.
- The study included 217 patients aged 1 month to 21 years with diverse heart conditions.
- Data collected included procedural success rates, complications, and patient demographics.
Main Results:
- The procedure was successful in 215 out of 217 patients (99% success rate).
- Minor complications, such as pericardial puncture (1.4%), occurred without significant sequelae.
- No mortality or major morbidity was observed during the study period.
Conclusions:
- Transseptal left heart catheterization is a safe and highly effective method for accessing the left side of the heart in pediatric populations.
- This technique facilitates both diagnostic studies and interventional procedures, offering an alternative to retrograde femoral catheterization.
- The Mullins technique provides a valuable approach for managing complex pediatric cardiac conditions.
Abstract:
Over a 5 yr period, from October 1983 to September 1988, transseptal left heart catheterisation, using Mullins long-sheath technique, was performed in 217 infants, children, and young adults, with various forms of congenital or acquired heart disease. The mean age was 50 +/- 45 months, (range 1 mo to 21 yr). The procedure was successful in 215 (99%) patients. Pericardial puncture occurred in three patients (1.4%), though without tamponade or sequelae. There was no mortality or morbidity. Transseptal left heart catheterisation is a safe procedure for studying the left side of the heart. In addition, and of increasing importance, it allows the performance of interventional procedures on the left side of the heart and avoids the use of retrograde catheterisation through the femoral arteries.